In 2011, approximately 230,480 new invasive breast cancer cases and 39,520 deaths were expected among US women. Breast cancer incidence rates remained stable across racial/ethnic groups from 2004 to 2008, while death rates have been declining since the early 1990s, except for American Indians/Alaska Natives. Disparities in death rates exist by state, socioeconomic status, and race/ethnicity. Mortality rates declined in 36 states and the District of Columbia over the past 10 years, but remained stable in 14 states. Mortality rates decreased more slowly in poor areas, shifting the highest death rates from affluent to poor areas in the early 1990s. Screening rates remain lower in poor women compared to non-poor women, despite progress in mammography utilization. In 2008, 51.4% of poor women had a screening mammogram in the past 2 years compared to 72.8% of non-poor women. Annual mammography and clinical breast exams are crucial for reducing breast cancer mortality. High-risk patients should be identified and offered appropriate screening and follow-up. Continued progress requires increased efforts to provide high-quality screening, diagnosis, and treatment to all populations. Breast cancer is the most common cancer among women, accounting for nearly 1 in 3 cancers diagnosed in the US. Incidence rates varied by race/ethnicity, with non-Hispanic white women having the highest rates and Asian Americans/Pacific Islanders the lowest. Mortality rates also varied, with African Americans having the highest rates. Disparities in mortality are attributed to differences in stage at diagnosis, survival, and access to treatment. Mortality rates declined for all racial/ethnic groups since the early 1990s, with the most significant declines among younger women. Survival rates varied by race/ethnicity, with African American women having the lowest 5-year survival rate and Asian American/Pacific Islander women the highest. State variations in mammography screening prevalence, breast cancer incidence, and mortality rates were significant. Screening rates were higher in affluent areas, but mortality rates were higher in poor areas. Screening rates for non-Hispanic white women ranged from 49.7% in Utah to 72.4% in Massachusetts. African American women had lower screening rates. Screening prevalence was positively correlated with in situ diagnoses and negatively correlated with late-stage diagnoses among non-Hispanic white women. African American women had higher rates of regional and distant stage diagnoses, possibly due to differences in screening quality and delayed follow-up. African American women were also more likely to be diagnosed with aggressive breast cancer subtypes, possibly due to racial differences in risk factors. Continued efforts are needed to reduce disparities in breast cancer outcomes.In 2011, approximately 230,480 new invasive breast cancer cases and 39,520 deaths were expected among US women. Breast cancer incidence rates remained stable across racial/ethnic groups from 2004 to 2008, while death rates have been declining since the early 1990s, except for American Indians/Alaska Natives. Disparities in death rates exist by state, socioeconomic status, and race/ethnicity. Mortality rates declined in 36 states and the District of Columbia over the past 10 years, but remained stable in 14 states. Mortality rates decreased more slowly in poor areas, shifting the highest death rates from affluent to poor areas in the early 1990s. Screening rates remain lower in poor women compared to non-poor women, despite progress in mammography utilization. In 2008, 51.4% of poor women had a screening mammogram in the past 2 years compared to 72.8% of non-poor women. Annual mammography and clinical breast exams are crucial for reducing breast cancer mortality. High-risk patients should be identified and offered appropriate screening and follow-up. Continued progress requires increased efforts to provide high-quality screening, diagnosis, and treatment to all populations. Breast cancer is the most common cancer among women, accounting for nearly 1 in 3 cancers diagnosed in the US. Incidence rates varied by race/ethnicity, with non-Hispanic white women having the highest rates and Asian Americans/Pacific Islanders the lowest. Mortality rates also varied, with African Americans having the highest rates. Disparities in mortality are attributed to differences in stage at diagnosis, survival, and access to treatment. Mortality rates declined for all racial/ethnic groups since the early 1990s, with the most significant declines among younger women. Survival rates varied by race/ethnicity, with African American women having the lowest 5-year survival rate and Asian American/Pacific Islander women the highest. State variations in mammography screening prevalence, breast cancer incidence, and mortality rates were significant. Screening rates were higher in affluent areas, but mortality rates were higher in poor areas. Screening rates for non-Hispanic white women ranged from 49.7% in Utah to 72.4% in Massachusetts. African American women had lower screening rates. Screening prevalence was positively correlated with in situ diagnoses and negatively correlated with late-stage diagnoses among non-Hispanic white women. African American women had higher rates of regional and distant stage diagnoses, possibly due to differences in screening quality and delayed follow-up. African American women were also more likely to be diagnosed with aggressive breast cancer subtypes, possibly due to racial differences in risk factors. Continued efforts are needed to reduce disparities in breast cancer outcomes.